Megan Perram’s research while affiliated with University of Alberta and other places

Through decades of scholarly analysis and application, the practice of illness narratives has been established as an effective therapeutic intervention for dealing with illness-related emotional well-being (Couser; Frank; Irvine and Charon). Scholars of illness narratives argue that the medium works to bring agency back to the body following the neoliberal relinquishing of one’s life story in the patient-physician encounter. Contemporary scholarly work is mapping the growth of illness narrative forms from the traditional book to emerging digital-born narratives; however, there is limited research on the medium’s intersection with virtual reality (VR) technologies. Working with Marie-Laure Ryan’s theoretical framework of possible worlds theory, this paper explores the transformative potential of VR illness narratives for pathologized identities found when VR resists the call to fall into one of two categories: pure transhumanism where VR reality is emancipated from actual reality or an artificial experience that has no lasting effect on the self.

Body dissatisfaction is so common in the western world that it has become the norm, especially among women and girls. Writing New Body Worlds is a transdisciplinary research-creation project that aims to address these issues by developing an interactive digital fiction for body image bibliotherapy. It is created with the critical co-design participation of a group of young women and non-binary individuals (aged 18–25) from diverse backgrounds, who are representative of its intended audience. This article discusses how our participant research influenced the creative development of the digital fiction, its characters and its novel ludonarrative or story-game design. It theorizes how the specific affordances of a choice-based interactive narrative, that situates the reader-player in the mind of the fictional protagonist, may lead to enhanced empathic identification and agency and, therefore, a more profoundly immersive and potentially transformative experience. This process of “diegetic enactment” is where we postulate the therapeutic value lies: an ontological oscillation between the reader-player’s mind and the fictional mind, which may induce the reader-player to reflect upon, and perhaps subtly alter, their own body image.

“Writing New Bodies: Critical Co-design for 21st Century Digital-born Bibliotherapy” is a research project funded by a Social Sciences and Humanities Research Council Insight Grant (2018-2020). Using methods of feminist participatory action research and critical community co-design to develop an interactive digital story app (i.e., digital fiction), this project creates a tool for media-enhanced bibliotherapy to help young women-identified and gender non-conforming individuals from diverse backgrounds build resilience to body image concerns. The project is a collaboration between digital humanities scholar Dr. Astrid Ensslin (Alberta), body image psychologists Drs. Carla Rice (Guelph) and Sarah Riley (Massey, NZ), as well as award-winning feminist digital fiction writer, artist, and game developer, Christine Wilks. (https://twitter.com/writenewbodies) (http://instagram.com/writingnewbodies)

Against the backdrop of écriture feminine and e-lit texts, Ensslin et. al advance methods and findings of the "Writing New Bodies" project ("WNB"; SSHRC IG 435-2018-1036; Ensslin, Rice, Riley, Bailey, Fowlie, Munro, Perram, and Wilks) to lay the foundations of Applied E-literature Research. Their aim is to develop a digital fiction for a new form of contemporary, digital-born bibliotherapy. In following the principles of critical community co-design and feminist participatory action research, WNB engages young woman-identified and gender nonconforming individuals ages eighteen to twenty-five in envisioning worlds where they feel at home in their bodies. The workshops encourage them to engage, conversationally and through reading, co-designing and writing digital fiction, with key challenges facing young women today, including cis-and heteronormative gender relations, racism, anti-fat attitudes, ableism, and familial influences on the ways young women "ought to look" (Rice). This essay originally appeared as a keynote at the 2019 ELO conference in Cork, delivered by Ensslin.

Objectives: To identify and summarize evidence on interventions to promote the adoption of shared decision-making (SDM) among health care professionals (HCPs) in clinical practice. Methods: Electronic databases including: MEDLINE, EMBASE, CINAHL, PsycINFO and Cochrane library were searched to determine eligible peer-reviewed articles. Grey literature was searched for additional interventions. Eligibility screening and data extraction were independently completed. Results are presented as written evidence summaries and tables. Results: Our search yielded 238 articles that met our inclusion criteria. Interventions mostly targeted physicians (46%), had multiple educational modalities (46%), and were administered in group settings (44%) before the clinical encounter (71%). Very few were developed based on the learning needs of targeted HCPs (24%). Many of the SDM outcome tools used for evaluation were developed for the respective study and lacked evidence of validity and reliability (30%). Conclusion: We identified a sizable number of interventions to promote the adoption of SDM, however, these interventions were heterogeneous in their assessments for effectiveness and implementation. Therefore, it is a challenge to infer which strategies and practices are best to promote SDM adoption. Practice implications: The need for evidence-based standards for developing SDM interventions targeting HCPs and assessing acceptability, effectiveness and implementation is suggested.